When teenage pregnancy is a death sentence

Each year, more than 350,000 young women die after falling pregnant – one every two minutes. Now, a new international drive is under way to deliver contraception to poverty-stricken nations, and so slash mortality rates


Joventa Kyasiimire is defiant. As we stand with hundreds of young women queuing in Uganda's midday sun outside Kanungu health centre, she is telling me how she fell pregnant unexpectedly in September 2010 aged 17, how her boyfriend fled a week after he found out she was expecting and how, just days later, she learnt she was HIV positive. Ostracised by many in her community, Kyasiimire left school to look after her son, Godias, now 11 months, giving up her dreams of becoming a teacher.

Now selling home-grown vegetables in an attempt to provide for Godias, Kyasiimire doesn't sound like she has much to be grateful for, except that Godias, mercifully, is not HIV positive. Yet many teenage girls in her circumstances fare worse: unintended pregnancy is the biggest killer of teenage girls in the developing world. Young women aged 15 to 19 are twice as likely to die from complications in pregnancy as are women in their twenties. For mothers under 18, their babies' chance of dying in the first year of life is 60 per cent greater than that of a baby born to someone aged 19 or older.

The fact that Kyasiimire and so many other women are in this snaking queue is a sign of hope. Soon she will be injected with a contraceptive implant, inserted under the skin of her upper arm, that will protect her from the risk of another unwanted pregnancy for the next three years.

Though it took Kyasiimire a couple of hours to walk to this rural clinic from her home in south-west Uganda, she is no longer one of the 215 million women around the world – with no means of accessing contraception – who want to avoid pregnancy, or at least want to choose when they have their children. These women account for 82 per cent of the 75 million unintended pregnancies that occur globally every year. Access to family planning services could reduce the number of maternal deaths by a third.

The need for money – and awareness campaigns – to help these women is so critical that the British government and the Bill and Melinda Gates Foundation are holding a summit on family planning in London next month. They aim to provide 120 million of the world's poorest women with access to contraception over the next eight years, at an estimated cost of almost £2.6bn.

A report to be launched in Parliament on Tuesday by Andrew Mitchell, the International Development Secretary, will reveal that though in the developed world 60 to 80 per cent of women have access to contraception, in sub-Saharan Africa the figure is below 20 per cent. On current trends, south Asia will not reach 60 per cent for 20 years, east Africa for 45 years and central and western African for a startling 500 years, according to the reproductive health charity Marie Stopes International.

Like so many of the women around us, Kyasiimire says she was too young to have a child when she did. She looks at her son, now balanced on her hip, and adds quietly: "If I had known about contraceptives before, I would have taken them."

Unlike in the West, pregnancy is not primarily a matter of lifestyle. Here, it is a life and death issue. Dana Hovig, chief executive of Marie Stopes International, said: "Every year 358,000 women die due to pregnancy or childbirth – that's one woman every two minutes. Many of those women did not plan to be pregnant. Equally tragic is that 47,000 women die every year because of unsafe abortions."

The issue of contraception has long been a political hot potato, especially in the United States. In 2002, the Bush administration withdrew US money for the United Nations Population Fund, claiming it financed forced abortions. The Obama administration has since restored the funding; it is estimated that an additional 90,000 lives could still be saved every year if there was more family planning provided.

Babatunde Osotimehin, executive director of the UN fund, said that teenage pregnancy was the "big issue" to be addressed at next month's summit: "In most African countries, 60-70 per cent of the population are under the age of 30. Family planning is the most important human development intervention there is: it enables young people to make choices about their lives; it ensures women can have the number of children they want and can look after; and it gives them the possibility to protect themselves from infectious diseases."

The statistics, translated into the real world, are devastating. Kyasiimire lives in a district where half of the teenagers have children, in a country where a quarter of all teenage girls are mothers. While government policy states adolescents should have access to comprehensive family planning, there is a stigma to supplying contraceptives to teens, getting them into the clinics and dispelling the myths that surround the services.

Around 10 per cent of births in Uganda involve girls under 15, according to Reproductive Health Uganda, which notes that the east African country's population growth rate – at 3.3 per cent each year – is one of the highest in the world.

The UK – until very recently the teenage pregnancy capital of Europe – now has the lowest under-18 conception rate since 1969, down to 35.5 conceptions per thousand women aged 15 to 17.

As we enter Kanungu health centre, the waiting rooms are filled with young mothers. Kate Tumuhimbes, 26, first fell pregnant at 14 and now has three children, with one more on the way. Her first delivery was so painful she had to give birth on her hands and knees.

Beatrice Niwabine, 19, fell pregnant for the first time at 16 and is now expecting her second child. Unable to provide for her son, Owen, she says quietly that she wished she had waited until she was older to give birth.

But Kyasiimire is hopeful. She is one of 37,000 people in Uganda who the UN-funded family planning clinics have reached since 2010. The Ugandan government will soon announce that for the first time in years, the country's fertility rate has fallen – from 6.7 babies per woman to 6.2 – and modern contraceptive use has increased from 18 to 26 per cent. "Life is starting to normalise," she tells me, before she leaves. "Finally, I have control over my decisions."

people'It can last and it's terrifying'
Danny Welbeck's Manchester United future is in doubt
footballGunners confirm signing from Manchester United
footballStriker has moved on loan for the remainder of the season
footballFeaturing Bart Simpson
Have you tried new the Independent Digital Edition apps?
ebooksAn unforgettable anthology of contemporary reportage
Arts and Entertainment
Olivia Colman topped the list of the 30 most influential females in broadcasting
Kelly Brook
peopleA spokesperson said the support group was 'extremely disappointed'
The five geckos were launched into space to find out about the effects of weightlessness on the creatures’ sex lives
Life and Style
techIf those brochure kitchens look a little too perfect to be true, well, that’s probably because they are
Andy Murray celebrates a shot while playing Jo-Wilfried Tsonga
TennisWin sets up blockbuster US Open quarter-final against Djokovic
Arts and Entertainment
Hare’s a riddle: Kit Williams with the treasure linked to Masquerade
booksRiddling trilogy could net you $3m
Arts and Entertainment
Alex Kapranos of Franz Ferdinand performs live
music Pro-independence show to take place four days before vote
news Video - hailed as 'most original' since Benedict Cumberbatch's
Life and Style
The longer David Sedaris had his Fitbit, the further afield his walks took him through the West Sussex countryside
lifeDavid Sedaris: What I learnt from my fitness tracker about the world
Arts and Entertainment
Word master: Self holds up a copy of his novel ‘Umbrella’
booksUnlike 'talented mediocrity' George Orwell, you must approach this writer dictionary in hand
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

SQL Implementation Consultant (VB,C#, SQL, Java, Eclipse, integ

£40000 - £50000 per annum + benefits+bonus+package: Harrington Starr: SQL Impl...

SQL Technical Implementation Consultant (Java, BA, Oracle, VBA)

£45000 - £55000 per annum + Benefits + Bonus: Harrington Starr: SQL Technical ...

Head of IT (Windows, Server, VMware, SAN, Fidessa, Equities)

£85000 per annum: Harrington Starr: Head of IT (Windows, Server, VMware, SAN, ...

Lead C# Developer (.Net, nHibernate, MVC, SQL) Surrey

£55000 - £60000 per annum + Benefits + Bonus: Harrington Starr: Lead C# Develo...

Day In a Page

'I’ll tell you what I would not serve - lamb and potatoes': US ambassador hits out at stodgy British food served at diplomatic dinners

'I’ll tell you what I would not serve - lamb and potatoes'

US ambassador hits out at stodgy British food
Radio Times female powerlist: A 'revolution' in TV gender roles

A 'revolution' in TV gender roles

Inside the Radio Times female powerlist
Endgame: James Frey's literary treasure hunt

James Frey's literary treasure hunt

Riddling trilogy could net you $3m
Fitbit: Because the tingle feels so good

Fitbit: Because the tingle feels so good

What David Sedaris learnt about the world from his fitness tracker
Saudis risk new Muslim division with proposal to move Mohamed’s tomb

Saudis risk new Muslim division with proposal to move Mohamed’s tomb

Second-holiest site in Islam attracts millions of pilgrims each year
Alexander Fury: The designer names to look for at fashion week this season

The big names to look for this fashion week

This week, designers begin to show their spring 2015 collections in New York
Will Self: 'I like Orwell's writing as much as the next talented mediocrity'

'I like Orwell's writing as much as the next talented mediocrity'

Will Self takes aim at Orwell's rules for writing plain English
Meet Afghanistan's middle-class paint-ballers

Meet Afghanistan's middle-class paint-ballers

Toy guns proving a popular diversion in a country flooded with the real thing
Al Pacino wows Venice

Al Pacino wows Venice

Ham among the brilliance as actor premieres two films at festival
Neil Lawson Baker interview: ‘I’ve gained so much from art. It’s only right to give something back’.

Neil Lawson Baker interview

‘I’ve gained so much from art. It’s only right to give something back’.
The other Mugabe who is lining up for the Zimbabwean presidency

The other Mugabe who is lining up for the Zimbabwean presidency

Wife of President Robert Mugabe appears to have her sights set on succeeding her husband
The model of a gadget launch: Cultivate an atmosphere of mystery and excitement to sell stuff people didn't realise they needed

The model for a gadget launch

Cultivate an atmosphere of mystery and excitement to sell stuff people didn't realise they needed
Alice Roberts: She's done pretty well, for a boffin without a beard

She's done pretty well, for a boffin without a beard

Alice Roberts talks about her new book on evolution - and why her early TV work drew flak from (mostly male) colleagues
Get well soon, Joan Rivers - an inspiration, whether she likes it or not

Get well soon, Joan Rivers

She is awful. But she's also wonderful, not in spite of but because of the fact she's forever saying appalling things, argues Ellen E Jones
Doctor Who Into the Dalek review: A classic sci-fi adventure with all the spectacle of a blockbuster

A fresh take on an old foe

Doctor Who Into the Dalek more than compensated for last week's nonsensical offering